Exploiting Dentine Matrix Proteins in Cell-Free Approaches for Periradicular Tissue Engineering

Area of Science:

• Endodontics and regenerative medicine
• Stem cell biology and tissue engineering

Background:

• Periapical lesions (PL) in adult teeth present challenges for conventional antimicrobial therapies.
• Mesenchymal stem cells within periapical lesions (PL-MSCs) offer potential for tissue regeneration.
• A paradigm shift towards biologically driven endodontic treatments is emerging.

Purpose of the Study:

• To review the novel concept of using endogenous dentine extracellular matrix (dECM) components to treat apical periodontitis (AP) in mature permanent teeth.
• To summarize current knowledge on PL-MSCs and the inductive potential of dECM.
• To discuss clinical translation challenges and future research directions for dECM-based therapies.

Main Methods:

• Literature review summarizing conventional treatment issues, PL-MSC biology, dECM composition, and inductive potentials.
• Exploration of adapting treatment protocols for dECM and PL-MSC utilization.
• Identification of challenges and future research avenues for clinical translation.

Main Results:

• dECM components, at picogram levels, enhance PL-MSC proliferation, viability, migration, differentiation, and mineralization in vitro and in vivo.
• Topical application of dECMs may enhance regenerative mechanisms in diseased periapical tissues.
• Conventional antimicrobial therapies for AP have stagnant success rates and do not directly stimulate healing.

Conclusions:

• Exploiting endogenous dECMs as clinical tools holds promise for treating AP in mature permanent teeth.
• dECM-based therapies could offer advantages over conventional antimicrobial treatments by stimulating tissue regeneration.
• Further research is needed to overcome challenges for successful clinical translation of dECM and PL-MSC therapies.